Usuba Teruyuki, Toyama Yoichi, Watanabe Kazuhiro, Kashiwagi Hideyuki, Yanaga Katsuhiko
Department of Surgery, Jikei Kashiwa Hospital, Kashiwa, Tokyo, Japan.
Hepatogastroenterology. 2007 Jun;54(76):1302-4.
A 61-year-old male had undergone distal gastrectomy followed by right hepatectomy for alpha-fetoprotein-producing gastric cancer and liver metastasis. Subsequently, multiple lung metastases were detected by follow-up chest examinations. Despite treatment with TS-1/Irinotecan (CPT-11)/Cisplatin (CDDP) combination therapy, the metastases increased gradually in size and number. Combination therapy with TS-1/Paclitaxel (TXL)/CDDP was effective, as confirmed by marked reduction in tumor size on chest computed tomography. TS-1/TXL/CDDP chemotherapy was administered repeatedly for relapse of lung metastases. The relapse was controlled twice with this chemotherapy regimen, and the patient remains alive at 52 months after gastrectomy without pulmonary symptoms such as hemosputum. Although patients with postoperative lung metastases from AFP-producing gastric cancer have a dismal prognosis, our clinical experience suggests that TS-1/TXL/CDDP combination therapy may be a useful regimen for such conditions.
一名61岁男性因产甲胎蛋白胃癌伴肝转移接受了远端胃切除术及右肝切除术。随后，通过胸部随访检查发现了多处肺转移。尽管采用替吉奥（TS-1）/伊立替康（CPT-11）/顺铂（CDDP）联合治疗，但转移灶的大小和数量仍逐渐增加。胸部计算机断层扫描显示肿瘤大小显著缩小，证实替吉奥（TS-1）/紫杉醇（TXL）/顺铂（CDDP）联合治疗有效。针对肺转移复发，反复给予替吉奥（TS-1）/紫杉醇（TXL）/顺铂（CDDP）化疗。该化疗方案两次控制了复发，患者在胃切除术后52个月仍存活，无咯血等肺部症状。虽然产甲胎蛋白胃癌术后肺转移患者预后不佳，但我们的临床经验表明，替吉奥（TS-1）/紫杉醇（TXL）/顺铂（CDDP）联合治疗可能是治疗此类情况的有效方案。
